Remnant lipaemia

Remnant removal disease (RRD, also called remnant lipaemia, familial dysbetalipoproteinemia) (uncommon) in which there is a defect of apolipoprotein E. This is the major ligand that allows internalisation and subsequent metabolism of remnant particles derived from VLDL and chylomicrons. The consequence is accumulation of VLDL remnants called intermediate density lipoprotein (IDL) with cholesterol and triglycerides usually in the range 6-9 mmol/1. Patients experience severe macrovascular disease (as above). 

Patients with remnant lipaemia (RRD hyperlipidaemia) may respond excellently to diet, weight loss (and possibly the addition of a fibrate). 

Remnant removal disease (remnant lipaemia) responds to dietary modification and weight reduction (above) and a fibrate nicotinic acid and/or a statin may be added where there is failure to respond. 

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